Long hours 'impair' doctors' skills

Last updated at 09:49 07 September 2005

Long hours and overnight shifts worked by young doctors may leave them functioning as poorly as if they had downed a few drinks, according to a new study.

Thirty four trainee doctors in America showed similar impairments in vigilance, attention and driving skills after being on overnight duties and working a month of 90-hour weeks, compared with when they had consumed three to four alcoholic drinks after a month of 44-hour weeks with no overnight duties.

The findings were published in this week's issue of the Journal of the American Medical Association.

Most subjects were tested before new national requirements in America limited their work hours to an average 80-hour week.

J Todd Arnedt, a sleep psychologist who is a clinical assistant professor of psychiatry and neurology at the University of Michigan Medical School, Ann Arbor, said: "This adds to the growing evidence that sleep deprivation among medical residents (trainee doctors) significantly impairs their ability to perform, although it is important to note that we did not assess performance on specific medical tasks.

'Concerns'

"Our study, like others before it, does raise concerns about the performance of sleep deprived physicians-in-training and suggests that strategies aimed at reducing fatigue-related impairments are likely necessary."

The doctors were tested four times, in two separate sessions.

Two of the tests were done after they had worked a month of light duty without overnight shifts.

The tests were done before and after they had consumed three to four alcoholic drinks.

In the second session, they were tested on the day after an overnight shift that came at the end of a month of 90-hour work weeks that included overnight work every fourth or fifth night.

During this session, they were tested before and after drinking a non-alcoholic placebo beverage.

Skills on a driving simulator deteriorated in doctors who were tested after an overnight shift in the hospital and at the end of a month of heavy night work.

This was thought to suggest that the personal safety of doctors driving home after working all night might be at risk. The driving test found that doctors who had worked a month of 90-hour weeks with overnight shifts every fourth or fifth night performed about the same as when they had a blood alcohol count of 0.04 per cent after a month of 44 hour weeks of daytime shifts.

The attention and vigilance tests produced similar results.

The study was carried out by Dr Arnedt and doctors at Brown University, Providence, Rhode Island.